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Acute respiratory distress syndrome. Asthmatic status. Mendelssohn's syndrome



1. Patient S., 65 years old, suffers from bronchial asthma (hormone-dependent) for 15 years. The last attack of suffocation continues for the second day. Twice she called an ambulance. She was admitted to the intensive care unit in a state of asthma (stage II). Name the diagnostic criteria for stage II status, determine the IT sequence.

2. Patient K., 40 years old, was admitted to the clinic of surgical diseases with a diagnosis of acute intestinal obstruction. After examination, the diagnosis was confirmed. According to an emergency, the patient is taken to the operating room. During water anesthesia, the patient underwent regurgitation, followed by aspiration of the gastric contents into the respiratory tract. Identify preventive measures complications, methods of diagnosis and therapy.

3. Patient S., 70 years old, has been suffering from bronchial asthma for a long time (more than 20 years). Upon admission to the intensive care unit unconscious, acrocyanosis, expiratory dyspnea up to 40 min, BP 60/20 mm Hg, pulse 120 min. In the lungs, a significant weakening of the breath, areas of "dumb lung." Determine the stage of asthmatic status, IT sequence.

4. Patient I., 57 years old, was in the traumatology department for a fracture of the pelvis and hip bones. In the history of the patient twice suffered a myocardial infarction. Dyspnea worries before admission to the hospital. Laboratory established a decrease in hemoglobin to 60 g / l. HELL upon admission to the intensive care unit 80/40 mm Hg In order to correct hypotension polyglukine 400 ml is intravenously transfused. Dyspnea appeared on the background of transfusion up to 40 per minute, blood pressure is stored at 80/40 mm Hg. Auscultatory weakened vesicular breathing with a mass of moist rales. The probable causes of this ARS, re-evaluation plan and IT.

5. Patient M., 50 years old, transferred to the intensive care unit with a pronounced respiratory failure clinic. In history: 10 days ago, operated on for acute intestinal obstruction. Postoperative peritonitis developed in the postoperative period due to insolvency of the anastomotic sutures. Upon admission to intensive care: sopor, acrocyanosis, tachypia up to 45 per minute, tachycardia up to 130 per minute, BP 70/40 mm Hg. In the lungs, auscultatory - hard breathing, single wheezing, hemoglobin saturation 80%. Radiographically - "snowstorm." Determine the probable cause of ARF, the pathophysiological explanation of the clinical and X-ray picture, pre-examination, IT.

6. Patient K., 60 years old, was in the department of thoracic surgery with a diagnosis of bronchiectasis.
Based on the clinical and radiological examination, the patient decided to undergo surgery. Against the background of mechanical ventilation, a sharp increase in inhalation resistance appeared against the background of manipulations on the lung root without local anesthesia. Against this background, the patient had a sharply increasing hypoxemia clinic. Necessary: ​​to clarify the cause of ARF, to determine the nature of IT.

7. Patient M., 70 years old, was in the department of general surgery after laparotomy, resection of the small intestine for acute small bowel obstruction. In the postoperative period more than 3 liters of isotonic solutions are transfused to the patient within 6 hours. In connection with the development of the clinic, he was transferred to the intensive care unit. It is necessary: ​​to name the most probable causes of ARF, determine pathophysiological mechanisms, designate an additional examination plan and establish IT sequence.

8. Patient B., 40 years old, was in the Department of Traumatology with a fracture of the femoral and tibial bones on the right. After 2 days, the patient developed OND clinic: shortness of breath up to 40 per minute, harsh breathing, radiographically - increased pulmonary pattern. Laboratory: established the presence of free fatty acids in the urine and blood. In terms of KHS: an increase in pCO2 to 57 mm Hg. Give a pathophysiological explanation, the cause of ARF, determine the parameters of IT.

9. Patient K., 68 years old, was in the therapeutic department for hypertension, stage II B. Against the background of the treatment, the patient experienced a sharp increase in blood pressure to 240/120 mm Hg. At the same time, the clinic grew by ONE: tachypnea up to 40 min, acrocyanosis, heart rate up to 120 min. In lungs moist various rales are listened, on an ECG - an overload of the left parts of the heart. Disturbed cough with frothy sputum mixed with blood. Identify the cause of the deterioration, assign a survey and IT plan.

10. Patient T., 54 years old. Entered the surgical clinic with acute intestinal obstruction. In the history of the patient suffers from prolonged bronchial asthma. After the survey and premedication for emergency indications, an operation was performed in the volume of laparotomy, the elimination of obstruction. Against the background of the introduction of fentanyl, the patient's condition worsened: BP increased to 240/110 mm Hg, tachycardia to 120 per minute, reduction in saturation to 83%. According to the data of the acid-chemical barrier: pCO2 increased to 60 mm Hg. Auscultation - a sharp weakening of the breath in all the pulmonary fields. Give a clinical assessment of preoperative preparation, determine the cause of deterioration, determine the nature of IT.

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Acute respiratory distress syndrome. Asthmatic status. Mendelssohn's syndrome

  1. Syndrome of acute lung injury and acute respiratory distress syndrome
    Acute lung damage (ALI) and acute respiratory distress syndrome (ARDS) are non-specific damage to the lung parenchyma of a polyetiological nature and are characterized by: • ????? acute onset; • ???? progressive arterial hypoxemia; • ???? bilateral infiltration of the lung fields on the radiograph of the chest; • ???? progressive decline
  2. Acute respiratory distress syndrome. Adult respiratory distress syndrome [distress]
    ICD-10 cipher J80 Diagnostics When making a diagnosis Mandatory Level of consciousness, respiration rate and efficiency, pulse, blood pressure, body temperature, history, physical examination R-graphy of the chest organs Blood gases Additional (if indicated) CVD DZLA During treatment Monitoring according to p.1.5 Additionally saturation of hemoglobin, hourly diuresis, blood gases,
  3. Acute Respiratory Distress Syndrome
    Causes of Acute Respiratory Distress Syndrome • ???? Shock. •????Sepsis. • ???? Multiple organ failure. • ???? Acute pancreatitis. • ???? The toxic effects of high respirable oxygen concentrations. • ???? Smoke poisoning. • ???? DIC syndrome. • ???? The use of certain drugs. • ???? Aspiration, incl. water when drowning. • ???? Fat embolism. • ???? Bruise of the lungs.
  4. Acute Respiratory Distress Syndrome
    In recent years, more and more attention is paid to a peculiar form of ARF, which is called "acute respiratory distress syndrome" (Acute respiratory distress syndrom - ARDS). By acute respiratory distress syndrome (ARDS), we mean a severe, life-threatening form of acute parenchymal respiratory failure, developing as a nonspecific phase reaction of previously intact
  5. Intensive treatment of asthmatic status, pulmonary edema, acute respiratory distress syndrome
    1. Obstructive ventilation disorders are caused by: 1) Edema of mucous membranes 2) Laryngospasm 3) Bronchospasm 4) Hematoxia 5) Inhibition of the respiratory center Answers: a) correct 1,2,3; b) correctly 1,2,5; c) 2,3,4 correctly. 2. Lung ventilation disorders are observed with: 1) Pneumothorax 2) Laryngospasm 3) Action of muscle relaxants 4) Barbiturate poisoning 5) Increased abdominal pressure
  6. Respiratory Distress Syndrome
    Michaels. Lagutchik, DVM 1. Give a definition of respiratory distress syndrome, dyspnea, tachypnea, orthopnea, hyperventilation, hypoventilation and apnea. Respiratory disorder (respiratory distress syndrome) - clearly obstructed ventilation of the lungs or ventilation requiring respiratory effort; clinically severe inability to ventilation and / or adequate oxygenation. Such a definition
  7. Adult Respiratory Distress Syndrome
    Adult respiratory distress syndrome (ARDS; synonyms: noncardiogenic pulmonary edema, “shock lungs”) are acute diffuse parenchymal pulmonary infiltration resulting from damage and increased permeability of pulmonary microvessels. RDSV is characterized by severe hypoxemia, resistant to oxygen therapy, a significant decrease in the elasticity of the lungs and pulmonary volumes, late
  8. Adult Respiratory Distress Syndrome
    RDSV (Adult respiratory distress-syndrome) is a severe form of respiratory failure characterized by specific changes in the lungs - diffuse infiltration, accompanied by non-cardiogenic edema, alveolar collapse, ODN. Despite the difference in etiological factors, they directly or indirectly affect the lungs, causing damage to the pulmonary structures. The main symptom of the syndrome
  9. RESPIRATORY ADULT DISTRESS SYNDROME
    RDSV (Adult respiratory distress-syndrome) is a severe form of respiratory failure characterized by specific changes in the lungs - diffuse infiltration, accompanied by non-cardiogenic edema, alveolar collapse, ODN. Despite the difference in etiological factors, they directly or indirectly affect the lungs, causing damage to the pulmonary structures. The main symptom of the syndrome
  10. Respiratory Distress Syndrome
    RDS is a predominantly premature neonatal disease caused by pulmonary maturity and surfactant deficiency. RDS is manifested by the development of NAM immediately after delivery or after a few hours with an increase in severity until the gradual start of recovery of survivors (usually between the 2nd and 4th day of life). RDS develops in about 20% of premature newborns, and among those born before
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